SGR is Finally on its Way Out. Maybe.

Joe Cantlupe, for HealthLeaders Media , November 7, 2013

As Gilberg sees it, reform is possible if Congress moves quickly in the remaining two months this year, or early next year.

If Congress doesn't act early next year, that could mean trouble for any SGR changes because "next year is an election year and the closer you get to an election, the more polarizing it would be, and it would be difficult again," Gilberg said, referring to House and Senate elections. "I can't think of a more dysfunctional situation in Congress right now."

Other experts are even more optimistic.

"This time, it looks like the effort could actually succeed," writes Bob Doherty, Sr. VP of government affairs for the American College of Physicians in a blog. (The ACP staff pointed me to Doherty's blog when asked for comment). "Never before has there been agreement between the House and Senate, Republicans and Democrats on a plan to repeal the SGR, never mind on what they would replace it with. Their goal is to get the bill enacted and signed into law before the end of the year."

According to the American College of Physicians, under the Senate committees' SGR elimination plan, physicians will have the opportunity to earn additional Medicare incentive payments, above the zero percent annual baseline updates, for participating in a new Medicare Value Based Incentive Program, which would replace the existing Medicare Physician Quality Reporting Program, Meaningful use for electronic health records, and Medicare value-based modifier program.

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